Background: Prediabetes is increasingly common in adolescent populations, yet, little is known about the contributing role of dietary behaviors throughout childhood to risk of prediabetes in adolescence.

Objective: We examined longitudinal associations of dietary behaviors throughout childhood with body mass index z-scores (BMI-z) and HOMA-IR index in adolescence.

Design: Among 596 children from Project Viva, a pre-birth cohort from eastern Massachusetts, we examined associations of maternal- or child-reported dietary behaviors annually from ages 4 to 12 years with BMI-z and HOMA-IR in adolescence (median 12.8 years). We used mixed effects models adjusted for: maternal education, pre-pregnancy BMI, marital status and parity, and child’s age, sex, and race/ethnicity.

Results: The frequency of healthful dietary behaviors decreased with advancing age; at age 12, 64% of children ate breakfast daily, 32% ate dinner together with family daily, 59% ate fast food meals <1x/week, and 50% watched television during meals <1x/week. BMI-z (mean 0.44 units, SD 1.06) in adolescence was lower in children who reported daily breakfast eating (β -0.17; 95% CI -0.25, -0.08), daily family dinner (-0.11; -0.17, -0.05), fast food <1x/week (-0.11; -0.18, -0.05) and television during meals <1x/week (-0.07; -0.13, -0.01) throughout childhood. Log-transformed HOMA-IR (mean 0.99, SD 0.62) in adolescence was also lower with daily breakfast (β -0.12; 95% CI -0.17, -0.07), daily family dinner (-0.05; -0.09, -0.01), eating fast food <1x/week (-0.05; -0.09, -0.01) and television during meals <1x/week (-0.05; -0.08, -0.01) throughout childhood. Association of daily breakfast eating with lower HOMA-IR remained significant after further adjustment for child’s BMI-z in adolescence (β -0.08; 95% CI -0.13, -0.04).

Conclusions: Children with healthful dietary behaviors throughout childhood have lower BMI-z and less insulin resistance in adolescence.


V. Gingras: None. S. Rifas-Shiman: None. E.M. Taveras: None. E. Oken: Employee; Spouse/Partner; Novartis Pharmaceuticals Corporation. M. Hivert: None.

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